All-Polyethylene Tibial Components in Obese Patients Are Associated With Low Failure at Midterm Followup

@article{Dalury2012AllPolyethyleneTC,
  title={All-Polyethylene Tibial Components in Obese Patients Are Associated With Low Failure at Midterm Followup},
  author={David F. Dalury and Kimberly K. Tucker and Todd C. Kelley},
  journal={Clinical Orthopaedics and Related Research{\textregistered}},
  year={2012},
  volume={470},
  pages={117-124}
}
BackgroundIn the United States, the obese population has increased markedly over the last four decades, and this trend continues. High patient weight places additional stress on TKA components, which may lead to increased polyethylene wear, osteolysis, radiolucencies, and clinical failure. Metal-backed tibial components and all-polyethylene tibial components in the general population have comparable osteolysis and failure, but it is unclear whether these components yield similar osteolysis and… 

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References

SHOWING 1-10 OF 55 REFERENCES

All-polyethylene and Metal-backed Tibias Have Similar Outcomes at 10 Years: A Randomized Level I Evidence Study

The 8- to 12-year followup of the earlier reported prospective randomized comparison of a modern congruent all-polyethylene tibial component with a modular metal-backed tIBial component of the same design found that the contemporary all- polyethyleneTBI component functioned equivalently to its monoblock counterpart and was less costly.

A Randomized Comparison of All-Polyethylene and Metal-Backed Tibial Components

Total knee arthroplasty with a well-designed, contemporary congruent all-polyethylene tibial component functions equivalently to its metal-backed tibia counterpart at 3-to 5-year followup in this patient population, and is less costly ($675).

Excellent Survival of All-polyethylene Tibial Components in a Community Joint Registry

Total knee arthroplasty with one of the three contemporary congruent all-polyethylene tibia designs used in this registry performed extremely well in this population; savings for this group (compared to those with a metal-backed component) was estimated at $729 per case.

Matched-pair analysis of all-polyethylene versus metal-backed tibial components.

The use of a more cost-effective all-polyethylene tibial component in elderly patients (>70 years old) who are not likely to need the versatility of exchange of a modular polyethylene insert because of wear is advocated.

All-polyethylene compared with metal-backed tibial components in total knee arthroplasty at ten years. A prospective, randomized controlled trial.

The long-term results demonstrate excellent survivorship, with revision as the end point, for both the metal-backed and the all-polyethylene tibial component designs with no differences noted between the two.

Metal-Backed and All-Polyethylene Tibial Components in Total Knee Replacement

Metal backing and modularity were added to the Press Fit Condylar ® total knee replacement design to improve fixation durability, however, the superiority of the modular metal-backed implants remains in question.

Survivorship comparison of all-polyethylene and metal-backed tibial components in cruciate-substituting total knee arthroplasty—Chinese experience

The results of this series of TKA using all-polyethylene tibial components in Chinese people are comparable to the satisfactory results of other reported all- polyethylene series whose patients are mainly Western people.
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